Elder abuse in nursing homes: an ecological perspective

Population trends suggest that the next 20 years will witness a dramatic increase in the adult population aged 65 and older. Projected increases in the elderly population are expected to significantly increase the stress on family and professional caretakers. Stress, in the context of caregiving relationships, is a risk factor associated with increased prevalence of elder abuse in familial and institutional settings. As increasing numbers of older adults are moved from family caregiving to nursing home care settings, it becomes important to identify the pattern of elder abuse risk factors in nursing home facilities. An ecological model is proposed for better understanding the risk factors associated with elder abuse in nursing homes and the complex interaction of individual/person characteristics and contextual factors in institutional elder abuse. An ecological perspective to institutional elder abuse provides a framework for guiding and informing future research on the risk factors of nursing home abuse and, in turn, for the development of effective interventions and relevant social policies.     

Effects of neighborhood walkability on healthy weight: assessing selection and causal influences

Studies that examine the relationship between neighborhood characteristics and weight are limited because residents are not randomly distributed into neighborhoods. If associations are found between neighborhood characteristics and weight in observational studies, one cannot confidently draw conclusions about causality. We use data from the Utah Population Database (UPDB) that contain body mass index (BMI) information from all drivers holding a Utah driver license to undertake a cross-sectional analysis that compares the neighborhood determinants of BMI for youth and young adults. This analysis assumes that youth have little choice in their residential location while young adults have more choice. Our analysis makes use of data on 53,476 males and 47,069 females living in Salt Lake County in 2000. We find evidence of residential selection among both males and females when BMI is the outcome. The evidence is weaker when the outcomes are overweight or obesity. We conclude that studies that ignore the role of residential selection may be overstating the causal influence of neighborhood features in altering residents’ BMI.     

Population Growth in High‐Amenity Rural Areas: Does it Bring Socioeconomic Benefits for Long‐Term Residents?*

OBJECTIVE: A widely noted concern with amenity-driven rural population growth is its potential to yield only low-wage service-sector employment for long-term residents, while raising local costs of living. This research examines change in socioeconomic status during the 1990s for long-term residents of high-amenity, high-growth rural counties in the United States. METHODS: Using longitudinal data from the Panel Study of Income Dynamics, in combination with county-level information, we estimate growth-curve models to examine the extent to which the socioeconomic status of long-term residents is associated with amenity-related in-migration. RESULTS: We find that, on average, residents in high-growth, amenity-rich rural areas have higher income growth over time and higher levels of initial occupational prestige compared to those from other rural areas, but that socioeconomic gains are primarily for individuals with low baseline prestige. CONCLUSIONS: The socioeconomic gains made by long-term residents of high-growth, amenity-rich rural areas associated with net in-migration may be limited to individuals with low initial prestige and growth may be due to low-skill service-sector jobs.     

Preparedness of representatives for people with dementia in a self-directed program

ABSTRACT

Representatives enact their role as decision-making partners across the intersection of participant direction (PD) and dementia care. Self-rated preparedness for key dimensions of the role endorsed by a panel of experts in PD and dementia was assessed by telephone survey of 30 representatives of persons with dementia in a PD program. The sample (daughters 60%; Black 50%; rural 70%) was diverse in length of time in the role and additional responsibilities. They represented participants with moderate to advanced dementia and ≥ two additional chronic illnesses. Overall preparedness scores were in the pretty well to very well prepared range, with variation across dimensions and between individuals. Preparedness varied according to what has to be done day-to-day in dynamic or unpredictable situations, gauging decisional capacity, anticipating changing needs, ensuring safety, supporting a dementia-capable care team and negotiation. Stress was related to having a safety net of capable back-up supports and dementia care literacy. Areas of strength, individual variation and particular challenges along the trajectory of representing can guide development of support counselor interventions to provide representatives with tailored training and resources as they enable the benefits of PD for persons with dementia.     

Examining the impact of family services on homeless children

This study examined the impact on children of services delivered through a collaborative initiative designed to provide supports to working poor families who are homeless or at immediate risk of becoming homeless. Overall, a number of positive findings can serve to inform the development of promising intervention strategies for children in homeless families and highlight areas for further research. Along with improved housing status, there was a statistically significant improvement in the economic self‐sufficiency of the families served, regardless of whether they completed the full programme cycle. In addition, youth self‐report data indicated significant improvements in externalizing and internalizing behaviour. The ability to combine programme data with school data for participating children also made it possible to explore school performance outcomes. Although these results did not indicate a change in participants’ levels of attendance or reading performance, there was a statistically significant improvement in students’ math scores. Moreover, when participating children were compared with a group of students matched on their level of academic performance at baseline who had not received housing or homeless services, no significant differences were detected between groups post‐intervention, indicating that services may help reduce the risk of homeless students’ falling further behind their peers academically.     

After the Interview

This article is concerned with after the interview, a strip of time (Goffman 1974, p. 10) between the end of the formal interview and the culmination of leave-taking rituals. Although there is a considerable and growing literature on qualitative interviewing (Arksey and Knight 1999; Kvale 1996; Rubin and Rubin 1995; Weiss 1994), and some corridor talk about the meaning of off the record post-interview comments, this topic has received little attention in the published literature (but see DeSantis 1980 and Wenger 2001). And we think it is an important one, since it illuminates the interviewee's interpretation of the interviewer and interview process, and highlights aspects of the meaning of the topic, and of the interviewer, to the respondent (which is, after all, the endpoint of the qualitative interviewing method). Further, the question of what constitutes after the interview throws into relief the question of what is an interview.